The hospital in Rushville is small, but it’s a big deal in that city

Oct. 5--RUSHVILLE -- The story of Sarah D. Culbertson Memorial Hospital, which is approaching its 100th birthday, might best be summarized in a logo.

Or logos, more accurately. And the story behind them.

For years, Culbertson had been using a thick, blue cross as part of its brand. But this year, attorneys for the Blue Cross Blue Shield Association contacted Culbertson officials.

The multi-state federation of health-insurance companies accused the 22-bed hospital in the Schuyler County seat of violating a Blue Cross Blue Shield trademark. Culbertson officials pleaded ignorance.

Eventually, both parties agreed the Culbertson blue cross would fade into history.

John Kessler, the Culbertson CEO, called it an "opportunity" for the hospital to change its logo. That might be a slightly sardonic spin, given his ensuing comments during a recent interview.

"It was by big corporations," Kessler said about the change. "That's the kind of culture we don't want, that big-corporation-type culture in this community. Because it doesn't fit."

The new logo, which Culbertson Marketing and Communications Director Molly Sorrell spearheaded, still features a cross -- albeit a thin, powder-blue one. But its primary graphic element is a stylized heart.

That might fit better with how Culbertson employees see their hospital and its role in its city of about 3,000 residents located 70-some miles southwest of Peoria. Rushville's top civic leader feels the same way, evidently.

"The hospital is probably the life blood of the community, really," Rushville Mayor Carson Klitz said. "We're fortunate to have it."

A lot of rural hospitals appear to be in trouble financially. More than 20% are near collapse, according to a recent Texas A&M University report.

But despite not being part of a larger system like Peoria-based OSF HealthCare or UnityPoint Health, Culbertson appears to be in solid shape -- although its administrators said that's a challenge to maintain.

The personal touch

Not as challenging, perhaps, is maintaining the personal touch. That's a combination of rural realities and the dedication of the 200 or so Culbertson employees, according to Kessler.

"Typically in smaller communities, you know the patients by name when they come in, because they live down the street from you, or your grandparents knew them, or your uncles knew them. They're your buddies," Kessler said.

"When they come here, they know they're going to get taken good care of because they know who's taking care of them."

Such an ethic helped convince Lisa Adams to spend 25 years working at Culbertson in various roles, including executive assistant and human-resources specialist.

"I feel like this is my place," said Adams, who is retiring this month. "This is my hospital. I love it here. I love everything about it. I love the history about it."

That history began Feb. 15, 1921, when the hospital opened.

Frederick Culbertson, an Iowa native, had practiced medicine in Rushville since 1910. The lack of decent roads in the area impeded his efforts to see patients, and the lack of a hospital caused him to lose them.

The doctor was prepared to relocate his practice to Chicago. But his wife, Sarah, was from nearby Littleton and didn't want to leave her native area.

Sarah Culbertson secured a bank loan to fund a hospital in Rushville and managed it through the Great Depression and beyond.

"She kept this place going," Adams said. "I just think that is so neat -- a woman, back in that day."

Upon his death, in 1949, Frederick Culbertson willed the hospital to the residents of Schuyler County. The only stipulation was that the hospital be renamed for his wife, who died a few years earlier.

The original hospital building still stands, although administrative offices occupy most of it. Medical facilities fill multiple additions constructed over the years on a single-story campus that fills about three-quarters of a city block.

No formal analysis has been done regarding the hospital's economic impact on Rushville, according to facility and municipal officials. Klitz relies on his eyes.

"They bring a lot of people to town," Klitz said.

'We were struggling'

The Culbertson footprint has extended beyond its building. The hospital operates clinics in Astoria, Beardstown and Table Grove, as well as a medical-arts facility in Rushville.

Among services the hospital offers at its base are cardiopulmonary rehabilitation, chemotherapy, emergency care and a wound clinic. Some surgeries and minor medical procedures also can be performed.

"We do a lot of 'scopes and endoscopies," said Sorrell, a Rushvillian who spent part of her youth in Metamora. "We don't want to do everything, but what we do, we want to do well.

"If you're only doing one hip replacement a month, that is not sustainable for the hospital, and if you're the patient, you don't want to come somewhere where they're only doing one a month. You want to go somewhere where they're doing a couple a day."

The addition of specialties in neurology, orthopedics and pain management is being considered, Kessler said.

The Culbertson staff includes two physicians and about eight physician assistants and nurse practitioners. Specialists visit regularly from Quincy and Springfield; each city is a little more than an hour away.

On average, the hospital has about five patients occupying its beds daily, Sorrell said. The emergency room handles an average of 400 patients a month.

Culbertson is considered a Critical Access Hospital, a federal designation intended to ensure essential medical services in rural communities. Medicare reimburses such hospitals at 100 percent of their costs for various procedures and tests.

The Critical Access program helped Culbertson avoid going out of business in the early 2000s, according to Adams.

"We were paying bills late," she said. "We were struggling."

Now, the hospital has an annual budget of about $34 million and has enough cash on hand to operate for almost six months, according to Kessler. Anything above 90 days is considered good at a minimum.

'We can't lose the hospital'

But Culbertson is losing money right now based on its operations, Kessler said. Tax revenue is among money from other sources that is allowing the hospital to break even.

Changes in state regulations and gradual implementation of a $15-an-hour minimum wage also present looming financial challenges, according to Kessler and Gregg Snyder, who chairs the hospital's board of directors.

Such uncertainty helped prompt the board to agree to sell Culbertson Gardens, the hospital's independent-living facility in Rushville. That decision was announced in August.

"It's one of those hard decisions we have to make," Snyder said. "We can't afford to continue to carry it, even though we want to ensure everything we can to keep it in the community."

Attraction and retention of medical personnel to a relatively isolated area is a constant battle, Kessler and Snyder suggested. So is maintaining independence when larger health systems are scooping Culbertson counterparts.

In 2018, Memorial Hospital in Carthage -- a city about Rushville's size -- became affiliated with UnityPoint Health, which also operates medical facilities in Pekin and Peoria.

Earlier this year, OSF and Perry Memorial Hospital in Princeton announced they are exploring affiliation, among other possibilities.

It appears Kessler and Snyder don't want those fates to befall their organization, where size requires employees to wear multiple hats. Kessler even handled medical-courier duty recently when the usual volunteer corps was unable.

"I've been in system hospitals, and you don't lose some control, you lose all control," said Kessler, who came to Culbertson last year. "Whether it's a faith-based institution like OSF or a non-faith-based system, it's still going to be a huge change to your culture."

That culture, developed over a century, helped spawn physicians like the late Russell Dohner. He spent almost 60 years, from 1955 to 2013, practicing medicine in Rushville and gained national attention for never charging more than $5 for an office visit.

Dohner probably never needed a logo, either.

"I went out and spoke at the Gardens when we made the decision to sell. I believe everybody understands (why)," Snyder said. "I had a lot of comments of, 'Well, the biggest thing we can't do is lose the hospital.'

"That's the importance this community puts on this hospital. We can't lose the hospital."

Nick Vlahos can be reached at 686-3285 or nvlahos@pjstar.com. Follow him on Twitter @VlahosNick.

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